Steve Case’s Healthcare “Revolution”

He’s been developing it on the kinda-sorta QT for a couple of years now….. Steve Case, formerly of AOL and looking for something to do with his millions has decided to join the foray into healthcare, but with a new twist. He’s taking it to the public sector to create profit centers based on advertising and projects that range from e-health, to wellness centers to spa resorts in Arizona.

It’s HUGE! It’s going to make him a ton of money. And it may be YOUR money.

And don’t forget what I always say, “Health care is not about health or care. It’s about sickness and money.” So what else is new?

What’s new is his approach. I actually first heard about Case’s Revolution in the summer of 2005 and even invited Mr. Case to speak at a conference I was working on with a technology group. We hoped he would speak about how technology was reforming healthcare — but, alas — either we were too small and unimportant, or he was too busy. Hmmmm….

Here are some of the things Case is offering through the online version of Revolution:

A website that is supposed to beat all other websites for those who want to research their health and medical challenges online

The ability to record all your personal health records online for retrieval when you need them

The ability to have someone help you wade through the mess of medical bills and insurance payments

The ability to find a doctor or other provider to help you

The ability to critique the medical care you have received

In addition, he plans to:

Set up bricks and mortar “branded” health centers called “RediClinic” — meaning — the Starbucks of healthcare

Invite us to enjoy his health spas to become healthier

Manage our health and medical records, including figuring out how doctors can easily add to them — this is supposed to be a way to “manage our lives online”

plus a variety of other ideas — the sky is the limit!

As your friendly patient advocate, I have a few kudos and a couple of concerns about this Revolution which, you should also be aware, is the new darling of a few other well-known folks including Colin Powell and Carly Fiorina.

Kudos:

Our health care system cannot be fixed without some real out-of-the-box thinking — and this may be a good start. It may not be an ideal system, but it most definitely shakes up the status quo.

Case has the money, chutzpah and name recognition to be able to shake up more than a few of the folks (mostly insurance company heads) who have continued to collect their profits while refusing to budge from our current, broken system.

The more we talk about the needs of patients the more chance we can get to a better place for patients.

There are some good seeds of ideas here, and they are profitable, too. As much as I dog on healthcare and profitability, I recognize that it is probably a necessary evil to make the system work best for providers and patients. The balance of needs among the players has to work. Or — as my former boss, Eric Mower, used to say, “To be truly successful, everyone must benefit.”

Some criticism:

The website doesn’t have anything new on it at all. Every single aspect I can find is replicated elsewhere (most specifically WebMD and in some cases, my own DiagKNOWsis.org site). They claim to have info about 1,500 conditions and diseases — well, OK — those are easily found elsewhere. What about those conditions and diseases that are harder to find information about? There are blogs. So what? There are lots of blogs in other places. Like this one! All one needs to do is a quick google search and voila — there they all are. They want you to rate your doctors and your care. There are already a handful of sites that let you do that, and let others access the info to help them.

If the website is an example of his out-of-the-box thinking then…. <<yawn>>….. ho hum.

And my concerns, which more than balance out the comments above:

The very profit question I mentioned earlier, and the way Case is choosing to profit, are my biggest concerns. It’s not that I don’t think he should profit, it’s that I vehemently disagree with some of the ways he plans to do so.

For example: Case’s primary income, he states, will be from advertising. According to the New York Times, among the primary advertisers will be drug companies, although Case states they will work to “avoid any perception that a drug manufacturer, for example, might influence the information.”

Excuse me? “avoid any perception?” That’s not the same as saying “they WON’T influence the information,” is it? In fact, I would suggest that the minute revenues from any advertiser become substantial, they can’t HELP but influence the info, I don’t care WHAT the perception is! Case’s business model won’t be any different from the others out there that accept advertising, including WebMD, but PUH-LEEZE don’t make us patients out to be stupid! We know the differences between perceptions and realities. We may not be particularly discerning at times, but we do know the difference!

Another concern: despite the fact that Case told the New York Times his services would be free to its users, that is NOT what Revolution told me! In fact, I was invited to join Revolution Health last January — free for one year — and they would charge my credit card ($100 if memory serves me) next January. So unless they’ve changed their minds, there are a number of services, at least, that Revolution intends to charge for.

Again — it’s not that I don’t think they should charge! I just think bait and switch is a lousy approach.

Finally — I have very key and real concerns about privacy. I don’t want my personal information housed on servers that can be hacked any more than I want my credit cards listed on servers that can be hacked. You won’t find me using online Personal Health Records (systems for maintaining my health and medical information) anytime soon, anymore than I would use a financial manager online to record my credit card numbers or social security numbers.

If you aren’t concerned about the security of keeping these records online, you should be. You need to know that they can be shared with potential employers, any company you want to get any kind of personal insurance from (health or life) — any of a number of people who can use that information to make decisions about you.

So that’s my thinking today about Steve Case’s Revolution. I will watch it with cautious optimism. He gets big points for giving it a try, and few points for openness and honesty.

But it’s a start. Don’t forget: “Health care is not about health or care. It’s about sickness and money.”

Like this:

Trisha Torrey

Great posting. You really seem to be a very engaged health care consumer and I love your thoughts. One small point of clarification I’d like to make is that RevolutionHealth.com is, and always will be a free site. There are specific components of RevolutionHealth that are premium services, which is what I believe you are referring to when you mention you would be billed next January. These involve many offline, telephonic services where you can speak with a live person to help you navigate your health and claims questions.

Trisha,
PassportMD.com has been doing what RevolutionHealth sets out to do for the last few years. A free basic service so that people may utilize and easily create their own personal health record and a premium service for more sophisticated functionality. Revolution Health may have changed from pay model to free basic services as they see the trend and explosion of thousands of personal health record companies , and since they have financial muscle behind them they can afford to give it away as a measure of more rapid enrollment , growth, and way to entice users away from the thousands of other healthcare sites. In the end , I believe RevolutionHealth and companies like PassportMD.com will be better for the healthcare consumer, giving them more choice and more services. Ultimately market forces and trends will dictate to all of us in this business, what the “real model” will be. As to your point regarding security, as a physician and a healthcare information businessman… I think that the benefits of digitizing your medical information will far outweigh the risks associatied with security breaches (which are inevitable). Just as we have become comfortable to trade stocks, bank online, pay bills online, the eventuality of medicine information online is just around the corner. As a side note, those with very sensitive health information, ie those with AIDS or diseases often associated with certain stigmata, will, understandably , be the last to adopt these systems due to the consequences of breaches in their privacy. Those individuals are the minority, however, and the majority of people , have conditions that will not necessarily inhibit them from using online tools like PassportMD or RevolutionHealth.
Steven Hacker, MD
Founder & CEO
PassportMD, Inc.

Thanks for a great and balanced post. We at Direct Health Access, LLC completely agree with your assessment of the privacy issues involved in maintaining personal health records on line. The results of numerous surveys conducted by major organizations (e.g. Harris Interactive and the Markle Foundation) over the past few years bear out our contention that for the consumer to feel comfortable and in control of their medical information, they should be able to store and maintain their records OFF the Internet.

If the information is stored in an encrypted, portable format, as it is on our I.C.E. Alert device, it cannot be hacked into. In addition, the availability of summary health information with emergency contacts, allergies, medications, etc. provides a much more usable tool for first responders and emergency room personnel. We find it unlikely that EMS personnel on-scene, anywhere, are able to get reliable on-line access to garner the same data that we can provide immediately if the patient cannot speak for him or herself.

The slow crawl toward National adoption of interoperable electronic health records can be assisted by taking baby steps: providing patients with scanned medical, dental and eye records in an easily read format. All other industries have taken this approach, and it is just as valid for health care.

[…] few days ago I blogged about Steve Case (late of AOL and Time Warner) and his new healthcare “Revolution.&#82…I offered my cautious optimism about some of his pro-active approach to improving our dysfunctional […]